Provider Demographics
NPI:1356525422
Name:CHILD AND FAMILY SUPPORT SERVICES
Entity type:Organization
Organization Name:CHILD AND FAMILY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:P,
Authorized Official - Last Name:ELEFTHERIOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-376-8558
Mailing Address - Street 1:4 S 4TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-2820
Mailing Address - Country:US
Mailing Address - Phone:610-376-8558
Mailing Address - Fax:610-376-2779
Practice Address - Street 1:1455 MARION ST.
Practice Address - Street 2:12TH & MARION ELEMENTARY SCHOOL
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604
Practice Address - Country:US
Practice Address - Phone:610-376-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA209300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007782100002Medicaid